Individual provider Active NPI

Molly Kathleen Boyce Moeller, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1043440415
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201101821 Issued in NC
Practice address
2630 E 7TH St
Charlotte, NC 28204-4318
Phone
(704) 384-1000
Fax
(704) 384-1012
NPI assigned
Jul 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N2668 TX
Hospitalist Physician 208M00000X 2011-01821 NC
Pediatrics Physician 208000000X 201101821 NC Primary

Addresses

Primary practice location

2630 E 7TH St
Charlotte, NC 28204-4318

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-4021

Other practice location 1

200 Hawthorne Ln
Charlotte, NC 28204-2515
Phone (704) 384-4021

Other names 1

  • Molly Boyce Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoeller46538@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608000839 NC Practitioner - Pediatric MedicinePractitioner - Hospitalist 8224276712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201101821NCMDPediatrics Physician
N2668TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Hospitalist CurrentSince Apr 30, 2023 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 30, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

1718 E 4th St
Ste 707
Charlotte, NC 28204
Phone (704) 316-4485

2630 E 7th St
Ste 101
Charlotte, NC 28204
Phone (704) 344-1000

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: mmoeller46538@direct.novanthealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1043440415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-4021",
            "fax_number": "704-384-5601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044318",
            "telephone_number": "704-384-1000",
            "fax_number": "704-384-1012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawthorne Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042515",
            "country_code": "US",
            "telephone_number": "704-384-4021",
            "fax_number": "704-384-5601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOELLER",
        "first_name": "MOLLY",
        "middle_name": "KATHLEEN BOYCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-20",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N2668",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2011-01821",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "201101821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoeller46538@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "200 Hawthorne Ln",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "BOYCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.